Fuller Researchers Publish Study on Female North Korean Refugees

Seong-Hyeon Kim, assistant professor of psychology at Fuller Seminary, has published a new research study assessing the psychological features of female North Korean refugees resettled in South Korea.

The study, which has been published by the American Psychological Association's quarterly publicationPsychological Assessment, reveals that previous methods of assessing mental disorders in female North Korean refugees may have been incomplete.

"The purpose of the investigation was to uncover different groups of refugees using one of the most advanced statistical methods to date called latent profile analysis (LPA)," said Dr. Kim. "With conventional statistical analyses, researchers may find the mean scores of the overall research sample and, as a result, may not unearth apparently different groups of refugees with varied psychological profiles. This oversight can distort the true picture of the different mental status of dissimilar refugee subgroups and may translate into less than optimal clinical interventions for the distinct subgroups at hand."

Dr. Kim, along with doctoral student Narae Lee, analyzed data from 2,163 female North Korean refugees taken in 2008 and 2009 at Hanawon, a resettlement center for North Korean refugees in South Korea. All refugees are required to take the Minnesota Multiphasic Personality Inventory-2nd Edition (MMPI-2) as an initial psychological screen to assess mental disorders. Kim's analysis revealed four different groups or classes of North Korean female refugees with very distinct MMPI-2 patterns and resulting psychological features.

Forty-eight percent of refugees belonged to a nonclinical class who actually appeared healthy psychologically. A second group of North Korean female refugees was named thedemoralized class and made up 20% of the research sample. The individuals in the second class displayed moderate levels of anxiety, fearfulness, hostility and irritability. Approximately 22% of the participants were grouped into class three, the somatizedclass, because the persons of class three tended to translate their psychological stress into somatic or bodily symptoms and had heightened concerns regarding disease and illness. Lastly, class four received the name detached, as the individuals in this class favored relational isolation, bizarre sensory experiences, and a lack of a sense of reality.

"Recognizing the various subgroups can have significant impact on the clinical intervention prescribed for the psychological treatment of refugees," Lee said.

The new findings suggest some North Korean female refugees may have lacked sufficient treatment or received immature termination of mental health interventions, the report said. It also recommended more communication and coordination between physical and mental health care providers when dealing with members of a particular subgroup.

Other data suggested education acts as a protective factor against psychological issues for refugees; increased number of repatriations correlated with worse mental health outcomes; and older age contributed to increased psychological distress.

The study also found that having a religious faith increased the probability that North Korean female refugees will experience psychological issues, but it notes that the cause and effect relationship is unclear at this point. Further research in these areas will be needed.

Dr. Kim undertook the research project in 2009 after he heard of North Korean refugees in China facing repatriation. He prayed about how to help refugees using his skills as a psychology professor.

"I believe that was my calling for this specific group of people," he said. That same year, Dr. Kim flew to South Korea and contacted a psychologist at Hanawon and was able to obtain the dataset for his analysis.